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Ultrasound AND spondyloarthropathy

Ian M Ward, Eugene Kissin, Gurjit Kaeley, Joshua N Scott, Michelle Newkirk, Bernard A Hildebrand, Josh Lospinoso, Minna J Kohler, Jay B Higgs
OBJECTIVES: Limited literature exists on the sonographic appearance of the posterior tibialis (PTT) and the peroneus brevis (PBT) tendon entheses. We determined the anatomic features and best imaging techniques of normal PTT and PBT using musculoskeletal ultrasound and compared these findings to subjects with inflammatory arthritis. METHODS: Adult subjects were enrolled as: healthy controls (HC), rheumatoid arthritis (RA), and spondyloarthropathy (SpA). Bilateral PTT and PBT entheses were imaged longitudinally, comparing two angles of insonation: perpendicular to the skin surface and 45˚ cephalad...
December 20, 2016: Arthritis Care & Research
Steven Schaub, Hartley M Sirkis, Jonathan Kay
Multifocal osteomyelitis and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome constitute a spectrum of disease that includes inflammatory bone lesions and dermatologic findings. Radiographic features resemble those of the spondyloarthropathies with anterior chest wall involvement. Early radiographic findings are osteodestructive with lytic lesions. Bone scintigraphy of the sternoclavicular region classically yields a 'bull's head' pattern of radionuclide uptake. Magnetic resonance imaging (MRI) can demonstrate corner lesions of vertebral bodies...
November 2016: Rheumatic Diseases Clinics of North America
Joanna Zalewska, Małgorzata Węgierska, Tacjana Barczyńska, Marzena Waszczak, Paweł Żuchowski, Sławomir Jeka
OBJECTIVES: Hypertrophic and exudative synovitis of the knee is one of the earliest symptoms in rheumatic diseases. In the case of pharmacotherapy failure, other methods which directly remove the inflamed synovial membrane are used - synovectomies. Radiosynovectomy (RSV) is the radiopharmaceutical application of colloidal solution to joint cavities. In this study, the authors assessed the efficacy of knee radiosynovectomy with yttrium-90 (Y-90) in several groups of patients divided into certain rheumatic diseases...
2016: Reumatologia
Victoria H Wilkinson, Emma L Rowbotham, Andrew J Grainger
The foot and ankle are commonly involved in a range of arthritides that affect the joints, bones, and soft tissues. Accurate plain film interpretation can often aid the diagnosis and monitor disease progression and treatment response. Ultrasound and MRI afford superior depiction of the soft tissues, and advances over recent years have centered on early detection of synovitis, enabling earlier diagnosis and treatment. Advantages and disadvantages of the imaging techniques of radiography, multidetector computed tomography, ultrasound, and MRI are discussed, as is optimization of these modalities for the assessment of the anatomically complex joints of the foot and ankle...
April 2016: Seminars in Musculoskeletal Radiology
Mateusz Płaza, Anna Nowakowska-Płaza, Grzegorz Pracoń, Iwona Sudoł-Szopińska
In the past years, ultrasound imaging has become an integral element of the diagnostic process in rheumatic diseases. It enables the identification of a range of inflammatory changes in joint cavities, sheaths and bursae, and allows their activity to be assessed. In 2012, experts of the European Society of Musculoskeletal Radiology prepared recommendations concerning the role of ultrasonography in the diagnosis of musculoskeletal diseases. Ultrasound was considered the method of choice in imaging peripheral synovitis...
March 2016: Journal of Ultrasonography
Puja Srivastava, Amita Aggarwal
Ultrasound (US)-guided corticosteroid injection has been shown to be safe and effective for varied causes of plantar fasciitis; however, its use for Achilles tendinitis is controversial. We studied the efficacy and changes in US findings at Achilles enthesitis after corticosteroid injection in patients with spondyloarthropathy (SpA). Patients with SpA with symptomatic Achilles enthesitis, refractory to 6 weeks of full-dose NSAIDs, were offered US-guided local corticosteroid injection. Injected entheses were examined by US (both B mode and power Doppler) at baseline and 6 weeks after injection...
June 2016: Rheumatology International
Sajjan Shenoy, Amita Aggarwal
OBJECTIVES: Enthesitis is an important clinical manifestation and is a diagnostic criterion for juvenile idiopathic enthesitis-related arthritis (JIA-ERA). Ultrasound (US) is a highly sensitive method of detection of enthesitis in adult spondyloarthropathies. However, since the data on JIA and the preformance of US compared to clinical examination is limited, we aimed to compare the accuracy of US and clinical examination in JIA-ERA. METHODS: Patients with JIA-ERA (ILAR criteria) were enrolled in the study after consent...
January 2016: Clinical and Experimental Rheumatology
Iwona Sudoł-Szopińska, Brygida Kwiatkowska, Monika Prochorec-Sobieszek, Włodzimierz Maśliński
The pathologies of tendon and ligament attachments are called enthesopathies. One of its types is enthesitis which is a characteristic sign of peripheral spondyloarthropathy. Clinical diagnosis of enthesitis is based on rather non-specific clinical signs and results of laboratory tests. Imaging examinations are highly promising. Numerous publications prove that enthesitis can be differentiated from other enthesopathic processes in an ultrasound examination or magnetic resonance imaging. However, some reports indicate the lack of histological criteria, specific immunological changes and features in imaging examinations that would allow the clinical diagnosis of enthesitis to be confirmed...
March 2015: Journal of Ultrasonography
Kei Ikeda
Inflammation of soft tissues and the subsequent structural damage are the characteristic features of many rheumatic conditions. However, the conventional measures to evaluate these features are not accurate, potentially causing under- and over-diagnosis or treatment. Musculoskeletal ultrasonography, on the other hand, directly visualizes features which are characteristic to rheumatic conditions, such as synovitis, tenosynovitis, bursitis, enthesitis, crystal depositions, bone erosions, and osteophytes/enthesophytes...
May 2015: Rinsho Byori. the Japanese Journal of Clinical Pathology
Matthew Carroll, Nicola Dalbeth, Mark Boocock, Keith Rome
OBJECTIVE: Ultrasound (US) is a highly sensitive, reliable and non-invasive tool, which allows for the assessment of lesions of tendons and entheseal sites. The aim of this systematic review and meta-analysis is to identify differences in US lesions of the Achilles tendon (AT) between people with inflammatory arthritis (IA) and healthy controls. METHODS: An electronic literature search was performed on Medline, CINAHL, SportDiscus and The Cochrane Library. Methodological quality was assessed using a modified Quality Index...
August 2015: Seminars in Arthritis and Rheumatism
Santiago Ruta, Anthony M Reginato, Carlos Pineda, Marwin Gutierrez
Ultrasound (US) is a noninvasive imaging technique that continues to gain interest among rheumatologists because of its undoubted utility for the assessment of a wide range of abnormalities in rheumatic diseases. It also has a great potential to be used at the time of consultation as an extension of the clinical examination.Current data demonstrate that the standard clinical approach could result in an insensitive assessment of some the different aspects of the various rheumatic diseases for which US has become a feasible and effective imaging modality that allows early detection of anatomical changes, careful guidance for the aspiration and/or local treatment, and short- and long-term therapy monitoring at the joint, tendon, enthesis, nail, and skin levels...
April 2015: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Iwona Sudoł-Szopińska, Katarzyna Zaniewicz-Kaniewska, Brygida Kwiatkowska
BACKGROUND: Enthesitis is considered a characteristic presentation of the second most common group of rheumatoid disorders, i.e. spondyloarthropathies (SpAs), particularly peripheral spondyloarthropathies. At the initial stages, enthesitis may be the only symptom of SpA, particularly in patients lacking the HLA-B27 receptor. MATERIAL/METHODS: In light of diagnostic difficulties with detecting enthesitis in clinical examinations and laboratory investigations, many studies point out the high specificity of imaging studies, and particularly ultrasonography...
2014: Polish Journal of Radiology
T A Gheita, S Sayed, G S Azkalany, H S El Fishawy, M A Aboul-Ezz, M H Shaaban, R H Bassyouni
PURPOSE: The aim of this work was to detect subclinical sacroiliac joint involvement in patients with brucellosis and study their clinical and laboratory features. PATIENTS AND METHODS: The study included 100 brucellosis patients being followed-up in the Gastroenterology and Hepatology Unit, Theodor Bilharz Research Institute and Cairo University outpatient clinics. A thorough history, physical examination, routine laboratory tests, and abdominal ultrasound were obtained for all patients...
April 2015: Zeitschrift Für Rheumatologie
Iwona Sudoł-Szopińska, Katarzyna Zaniewicz-Kaniewska, Fadhil Saied, Wojciech Kunisz, Patrycja Smorawińska, Monika Włodkowska-Korytkowska
In recent years a dynamic development of ultrasound technology has been observed. Consequently, ultrasound is increasingly being utilized in rheumatology. With the introduction of high-frequency (up to 18 MHz) linear probes, sensitive Doppler techniques, harmonic imaging options and cross beams, ultrasound is used in the initial diagnosis of rheumatic diseases, monitoring of the effectiveness of treatment and confirmation of remission. Ultrasound cannot identify specific rheumatic diseases, but it does allow for an evaluation of the type of pathology, including an assessment of disease progression and its location...
2014: Polish Journal of Radiology
Ashraf Anas Zytoon, Hazem Eid, Ayman Sakr, Hatem Abou El Abbass, Mohammed Kamel
BACKGROUND: Enthesopathy is an evolving area for applied clinical research. MRI is the gold standard in the diagnosis of elbow joint pathology, but recent reports indicate that ultrasound imaging is more sensitive and accurate than MRI in detecting enthesopathy of the heels and knees. Too many patients are under-diagnosed and/or misdiagnosed because the early pathological changes of enthesitis in the different types of seronegative arthropathies are not detected. OBJECTIVES: This study was undertaken to describe the ultrasound features of elbow enthesitis in patients with seronegative arthropathies...
March 2014: Journal of Ultrasound
Catherine J Bakewell, Ignazio Olivieri, Sibel Z Aydin, Christian Dejaco, Kei Ikeda, Marwin Gutierrez, Lene Terslev, Ralf Thiele, Maria Antionetta D'Agostino, Gurjit S Kaeley
OBJECTIVE: Dactylitis, a characteristic feature of the spondyloarthropathies, occurs in up to 48% of patients with psoriatic arthritis (PsA). No clear consensus on the underlying components and pathogenesis of dactylitis exists in the literature. We undertook a systematic review of ultrasound (US) and magnetic resonance imaging (MRI) literature to better define imaging elements that contribute to the dactylitic digit seen in PsA. Our objectives were to determine first the level of homogeneity of each imaging modality's definition of the components of dactylitis, and second, to evaluate the metric properties of each imaging modality according to the Outcome Measures in Rheumatology Clinical Trials (OMERACT) filter...
December 2013: Journal of Rheumatology
Abdurrahman Tufan, Rıdvan Mercan, Mehmet Engin Tezcan, Arif Kaya, Berivan Bitik, Mehmet Akif Ozturk, Seminur Haznedaroglu, Berna Goker
Enthesopathy is pathology of bony insertions of tendons, ligaments or joint capsules. It is a frequent finding in rheumatic diseases, like ankylosing spondylitis (AS) and Behçet's disease. Musculoskeletal complaints are common in patients with familial Mediterranean fever (FMF), and these could be a clinical manifestation of enthesopathy. Hence, we investigated the possible association between FMF and enthesopathy. Fifty-six patients with FMF and 11 patients with FMF-associated spondyloarthropathy (FMFS) were enrolled...
August 2013: Rheumatology International
A Delle Sedie, L Riente, E Filippucci, C A Scirè, A Iagnocco, G Meenagh, M Gutierrez, G Valesini, C Montecucco, W Grassi, S Bombardieri
Psoriatic arthritis (PsA) is an arthropathy associated with psoriasis, which is part of the spondyloarthropathy family, and which may present with various forms, from mono-oligoarthritis to symmetric polyarthritis mimicking rheumatoid arthritis. In longstanding disease, the symmetric polyarthritis is the most common pattern of PsA, involving the small joints of hands, feet (the involvement of which seems to be very common, ranging from 50 to 100% of patients), wrists, ankles and knees. Other common features are represented by the inflammation of enthesis and tendons...
March 2011: Clinical and Experimental Rheumatology
Francesca Bandinelli, Monica Milla, Stefania Genise, Leonardo Giovannini, Siro Bagnoli, Antonio Candelieri, Ledio Collaku, Silvia Biagini, Marco Matucci Cerinic
OBJECTIVE: To investigate the presence of lower limb entheseal abnormalities in IBD patients without clinical signs and symptoms of SpA and their correlation with IBD clinical variables. METHODS: A total of 81 IBD patients [55 Crohn's disease (CD) and 26 ulcerative colitis (UC), 43 females and 38 males, mean age 41.3 (12.4) years, BMI 24 (2)] with low active (12) and inactive (67) disease were consecutively studied with US (LOGIQ5 General Electric 10-MHz linear array transducer) of lower limb entheses and compared with 40 healthy controls matched for sex, age and BMI...
July 2011: Rheumatology
Santiago Ruta, Marwin Gutierrez, Claudia Pena, Mercedes García, Alfredo Arturi, Emilio Filippucci, Juan Carlos Marcos
BACKGROUND: Ultrasound has demonstrated to be a highly sensitive tool in the evaluation of entheses in spondyloarthropathy (SpA) patients and improves the ability of clinical examination to detect enthesopathy. OBJECTIVES: The objectives of the study were to determine the prevalence of subclinical enthesopathy in SpA patients and to evaluate the reliability of ultrasound in the detection of abnormal findings indicative of enthesopathy. METHODS: Six hundred lower-limb entheses were assessed in 60 SpA patients without known history of entheseal involvement...
January 2011: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
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